Q&A: Going through sleep transitions with toddlers
By Gwenn Schurgin O’Keeffe, MD, FAAP
Your Kid’s Health, The Salem News
January 26, 2004

Q: My 2 1/2 year old is starting to give up her nap, and she still wakes up at 5:30 every morning. How can I get her to stay in bed longer?

A: Regardless of how well our kids sleep when they are infants, the majority of kids go through some sort of sleep transition during the toddler years. Giving up a nap is a milestone in the toddler years – and marks that our kids are moving towards the preschool years. Try to be consistent and either help her not nap or keep the naps no longer than an hour. Many 2-3 year olds still need some sort of nap or rest but long periods will interfere with the amount of sleep that child needs at night. For some kids, giving up the nap or having a reduced nap will be enough to get them to sleep longer in the morning. For others, however, they still wake up at that horribly early hour because their internal clocks are programmed to that time.

A child’s internal clock can be reset, but often not with the results you desire because your child will still need the same amount of sleep. To get her to sleep longer means keeping her up later at night – which for some kids mean keeping them up until your bedtime hour. Re-setting a child’s clock is not always easy. With some kids, you can slowly push their bedtime later but with others when they are ready to fall asleep that is it – they are out! Trial and error will be your guide.

The final consideration deals with just the issue of getting her to stay in bed longer. Consider not going to get her right away when she calls – whether in a bed or a crib. Some kids actually fall back to sleep with this strategy or distract themselves with their toys. If she is in a bed and leaves her room to go to your room, consider putting a gate on her door to keep her in her room longer. Then there is the “if you can’t beat ‘em, join ‘em” strategy that we used to do. We’d put on a video or a favorite cartoon, get a sippy cup or bottle of milk and some dry cheerios, and our wee ones would sit on our bed mesmerized and content – and we’d have a bit more time to wake up and rest. Not quite the same as real sleep but better than nothing.

A friend of mine sent me a funny email that read: “Why is my kid always getting sick - and when will it start to get better?!” Then she added in parentheses: “Actually, I already know what you are going to say: Silly girl, you kept your kid home until he was three, and then you sent him off to pre-school. What did you expect? Of course, he's getting sick all the time."

I joked with her that for a businessperson, she has good medical sense! Kids get 6-12 upper respiratory infections a year and it is always more intense the first year they are around other kids. It comes with the territory of living in the world and is actually healthy – it primes our immune systems for battling similar illnesses in the future. While for most kids, the amount of infections will decrease as they get older, some kids never seem to shake that pattern and may need a workup of their immune systems. Your pediatrician can help you determine if an immune workup is needed for your child.

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